Provider Demographics
NPI:1497963037
Name:CHAFFEE, RENEE CARMEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:CARMEN
Last Name:CHAFFEE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8808 PINLEY SPRING ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-5139
Mailing Address - Country:US
Mailing Address - Phone:702-358-3460
Mailing Address - Fax:702-947-4717
Practice Address - Street 1:8808 PINLEY SPRING ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-5139
Practice Address - Country:US
Practice Address - Phone:725-867-7990
Practice Address - Fax:702-947-4717
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP 1007235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1396831152Medicaid